Patients with Eprex® resistance may be able to maintain their hemoglobin levels on reduced dose Eprex®, but evidence for the efficacy and safety of an Eprex® dose reduction protocol is limited to small open-label studies. In contradistinction, perhaps escalating Eprex® doses to a maximum dose well above the recommended clinical practice guideline target is what is required to improve hemoglobin levels in these patients.